Unlisted procedure, extraocular muscle
CPT4 code
Name of the Procedure:
Unlisted procedure, extraocular muscle
Summary
An unlisted extraocular muscle procedure refers to any surgical intervention on the muscles outside the eyeball (extraocular muscles) that is not specifically categorized under existing medical codes. These muscles control eye movement and alignment.
Purpose
This procedure addresses issues related to the extraocular muscles, such as strabismus (misalignment of the eyes), nystagmus (uncontrolled eye movements), or other disorders affecting eye coordination and movement. The expected outcomes include improved alignment of the eyes, better control over eye movements, and relief from associated symptoms like double vision.
Indications
- Persistent or significant strabismus
- Uncontrolled nystagmus
- Diplopia (double vision)
- Poor eye coordination impacting vision
- Specific medical conditions affecting eye muscles (e.g., Graves’ disease)
Preparation
- Fasting may be required several hours before the procedure.
- Adjustment or temporary discontinuation of certain medications.
- Pre-operative assessment including ophthalmic examination and imaging studies for precise planning.
Procedure Description
- Administration of local or general anesthesia as needed.
- Making a small incision near the eye or through the conjunctiva (the membrane covering the white part of the eye).
- Identification and isolation of the affected extraocular muscle(s).
- Performing the necessary surgical intervention (e.g., repositioning, resecting, or lengthening the muscle).
- Closing the incision with fine sutures.
- Application of a sterile dressing if required.
Duration
The procedure typically takes between 30 to 90 minutes depending on the complexity.
Setting
This procedure is typically performed in a hospital, outpatient surgical center, or specialized eye clinic.
Personnel
- Ophthalmic surgeon
- Anesthesiologist or nurse anesthetist
- Surgical nurses and technicians
Risks and Complications
- Infection
- Bleeding
- Adverse reactions to anesthesia
- Overcorrection or undercorrection of eye alignment
- Rare risk of vision loss
- Inflammation or scarring
Benefits
- Improved eye alignment and coordination
- Reduction or elimination of double vision
- Enhanced functional vision and appearance
- Relief from associated symptoms
Recovery
- Mild discomfort or soreness may be experienced post-procedure.
- Application of eye drops or ointment to prevent infection and reduce inflammation.
- Avoidance of strenuous activities and swimming for several weeks.
- Follow-up appointments to monitor healing and effectiveness of the procedure.
- Full recovery typically occurs within a few weeks to a few months.
Alternatives
- Vision therapy exercises
- Prismatic lens glasses
- Botulinum toxin injections to temporarily weaken overactive muscles
- Observation and monitoring without active intervention
Patient Experience
Patients may experience mild pain or discomfort during recovery, managed with prescribed pain medications. It's common to have temporary double vision or blurriness, which typically resolves as healing progresses. Patient support includes guidance on post-operative care and reassurance of expected outcomes to ensure comfort and ease during the recovery process.